This acronym describes "Short-term acute care"

This is a system that contains a digital version of a patient’s paper chart.

Examples: Meditech, Epic, Cerner, CPSI, etc.

The United States federal government health insurance program for Americans who are 65 years of age or older

This acronym refers to point-of-service

Charges accumulating on a patient’s claim who is still receiving inpatient services and hasn’t been discharged

A metric for measuring claims which have no defects or special circumstances and have a timely payment as a subset of all claims

A file with claims sent to a payer, Institutional, services in a facility

HFMA

The 10th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list by the World Health Organization

This acronym describes "Long-term acute care"

This is a shared instance of a larger EMR (Epic, Cerner, etc.) that certain hospital systems can provide to smaller regional facilities. Often available at a lower cost but limited in customization options.

Supplemental health insurance for Medicare

This acronym refers to a treatment authorization request

When hospitals will hold a bill for a period of 3-7 days to allow departments to get their charges in

A calculation that compares the total dollar amount of claims that have been rejected by payers within a given time period to the total dollar amount of claims submitted within the same time period

A file with claims sent to a payer, Professional, a professional's time

AAHAM

A listing of every item, service or procedure that a hospital could provide

This is a designation given to eligible rural hospitals by CMS and was put in place to reduce the financial vulnerability of rural hospitals

•    25 or fewer acute care inpatient beds

•    Located more than 35 miles from another hospital

This is a subsystem of a hospital information system used for storing financial data, calculation healthcare costs, and providing billing information.

These are costs that are a patient's responsibility for hospitalization between day 61-90 days

A responsible party and/or insured party who is not necessarily the patient.

Hospital bills that have completed service but have not been billed to insurance yet

Outstanding charges that are the patient's responsibility that have not been successfully collected which are eventually written off and sent to a collection agency

An transaction set and electronic version of an Application Advice document, used to notify the sender of a previous transaction that the document has been accepted, or to report on errors

MGMA

A bill that uses several commonly used ICD-10 codes

This program is intended to increase access to primary care in rural communities, to receive certification, they must be located in rural, undeserved areas.

Prior to submitting claims, the organization/technology scrubs a claim and checks for errors then electronically transmits claim information that is compliant with HIPAA standards.

This term refers to an entity or a private company that has a contract with CMS to determine and to pay part A and some part B bills, such as bills from hospitals, on a cost basis and to perform other related functions

This is sometimes required by a patient’s insurance company to determine medical necessity, but does not guarantee benefits will be paid

Tracking of dollars not submitted to payers; when claims are tracked to make sure they are submitted to meet filing requirements, measured by how many "days" of revenue are sitting in the total unbilled

A calculation that compares the Total Outstanding A/R to Average Daily Revenue

A payment file sent back to the provider

AHIMA

A unique physician identification number, discontinued in 2007 and replaced by NPI

This acronym describes a "Skilled Nursing Facility"

The use of electronic information and telecommunications technologies to support long-distance clinical health care

This term refers to a request for additional documentation on the claim

This is also known as a waiver of liability, and is a notice a provider should give you before your receive a service.

An alphabetical list of accounts receivable with outstanding balances

A calculation that compares Total A/R Aged over 90 days to Total Accounts Receivable

A claims acknowledgement from an inquiry

A 10-digit provider id number

They make up more than half of all hospitals in the United States, they provide essential access to inpatient, outpatient and emergency services in rural communities

This software aims to rid medical claims of errors and omissions

This systems allows you to check Medicare beneficiary eligibility data in real-time and is used to prepare accurate Medicare claims, determine beneficiary liability, or check eligibility for specific services

This is a medical billing term to describe the employee who is a part of a group policy  

An institutional paper claim form

An inquiry transaction about a claim

A summary of daily patient treatments, charges and payments received

The prices that hospitals get paid from Medicare for certain services. CAHs receive different reimbursement given their designation otherwise. 

This is a method where Medicare signals back to provider that they are going to reject a claim, and therefore, allows the opportunity to fix before final adjudication

A confirmation of coverage

Used by hospitals and healthcare centers when submitting bills to Medicare and 3rd party payors for reimbursement

A file that contains information regarding the Patient Information Transaction set

Standardized code sets that are necessary for Medicare and other health insurance providers to provide healthcare claims that are managed consistently and in an orderly manner

This is a healthcare program that supports low-income families or individuals

A notice you receive from Medicare explaining the benefits received and not received

HIPPA-compliant files requesting eligibility details for a patient

An editor from the government that edits a variety dimensions/facets of a claim

A system that helps get claims out to secondary payers faster

A professional paper claim form

A file returned to Epic

The local coverage determination and editing system from CMS

Any information in a medical record that can be used to identify an individual

The HIPPA electronic transaction standards, replaced 4010

A unique number that identifies the patients’ medical record